Autism Spectrum Disorder (ASD) is characterized by severe and pervasive impairment in several areas of development: social interaction, communication and the presence of stereotyped behavior, interests, and activities. Autism Spectrum Disorders include Autistic Disorder, Asperger's Syndrome, Pervasive Development Disorder Not Otherwise Specified (PDD-NOS), and Childhood Disintegative Disorder. An individual classified as autistic shows delays in the development of social interaction, verbal and nonverbal communication and stereotyped behaviors, interests, and activities. Nonverbal communication represents two-thirds of all communication and facilitates social interaction. Examples of non-verbal behaviors in social interaction include eye contact or gaze, facial expression, gestures, body language and posturing. Asperger's Syndrome differs from other autism spectrum disorders by its relative preservation of linguistic and cognitive development. It is much like autism in that those affected may have difficulty picking up on social cues, body language, and speech pitch and tone, and they may have difficulty overall with social situations. Other similarities include dislike of routine changes, fixation or hyper focus on specific interests, talking a lot and about only their own interests, and increased sensitivity of one or more of the five senses. The Center for Disease Control and Prevention estimates that an average of 1 in 88 children in the U.S. has ASD.
Although there is no cure, autism is treatable and symptoms associated with autism often improve as children start to acquire language and learn how to communicate their needs. Early intensive treatment may allow for relatively normal development in the child and reduce undesirable behaviors. Applied early and intensively enough, studies have shown that as many as 50% of autistic children participating in such programs can be referred back to normal schooling and education. Available treatments for autism may include a combination of the following therapies: applied behavior analysis (ABA), structured teaching, speech and language therapy, social skills therapy, and occupational therapy. Autism therapies attempt to lessen the deficits and abnormal behaviors associated with autism and other autism spectrum disorders (ASD), and to increase the quality of life and functional independence of autistic individuals, especially children. Treatment is typically tailored to the child's needs. Training and support are also given to families of those with ASD.
Applied Behavior Analysis (ABA) is a scientifically proven evidence based approach to treating Autism and has become widely accepted among health care professionals and used in many schools and treatment clinics. ABA encourages positive behaviors and discourages negative behaviors in order to improve a variety of skills. The child's progress is tracked and measured. The gold-standard treatment for autism involves 30 to 40 hours per week of one-on-one work with a trained therapist.
Despite these evidence based treatment solutions a number of serious problems remain. First, ABA is very expensive. The recommended number of hours for intensive behavioral intervention is 25-40 hours per week of one-on-one therapy for two to three years. In some cases the costs are fully or partially covered by insurance, schools or state and federal programs, but in many cases it is not and requires the caregivers to pay for therapy directly out of pocket. Second very few people receive the recommended number of hours, the vast majority receive much less if any. Third, with the increase in diagnosis, availability of board certified therapist in metropolitan areas is becoming difficult while in rural areas it is severely lacking. Fourth, ABA therapists may be poorly trained or untrained. While top therapists have embraced naturalistic ABA therapy, flexible approaches to building emotional engagement, and other child-appropriate techniques, many ABA therapists are trained only in “discrete trials.” Discrete trials, which involve repeated attempts to get a child to respond appropriately, are appropriate in limited circumstances—and certainly not for 40 hours a week.
Additionally, other motion tracking platforms in the form of commercially available accelerometer enabled or augmented motion tracking gaming systems, such as the Kinect system from Microsoft, have been used in a supervised rehab setting by allowing patients to participate in entertainment programs specific to the gaming platform.
Various attempts have been made to integrate interactive technologies into a useful tool for aiding in these efforts. For example, the Lakeside Center for Autism has utilized various touch screen technologies to support participation and learning. The University of Minnesota's Institute of Child Development has recently used the Microsoft Kinect motion detection system to monitor students, to look for signs of unusual behavior that might suggest potential ASD. Yet other vision based activity recognition and monitoring systems have been proposed for guided virtual rehabilitation. See, e.g. Dariush et al. US published patent application US 2011/0054870, hereby incorporated by reference. The system follows the sequence of providing instructions for guided movement, capture of the subject's movement, tracking the movements on an Avatar, calculation of biomechanical quantities, and providing feedback to the patient.
Despite these prior efforts and suggestions, no comprehensive or fully effective system has been proposed previously. The systems, apparatus and methods of the present inventions seek to remedy some or all of the shortcomings of the prior systems.